Nursing Elites

1. The healthcare professional is reviewing concepts of cultural aspects of pain. Which statement is true regarding pain?

• A. All individuals will behave the same way when in pain.
• B. Just as individuals vary in their perceptions of pain, they will also vary in their expressions of pain.
• C. Cultural norms play a significant role in determining pain tolerance, as it is always biologically determined.
• D. A patient's expression of pain is largely dependent on the amount of tissue injury associated with the pain.

Correct answer: B

Rationale: Patients vary in their perceptions of pain, which can be influenced by cultural factors, personal experiences, and psychological aspects. As a result, individuals will also vary in how they express their pain. Cultural norms, social environment, and individual differences all play a role in how pain is experienced and communicated. Therefore, it is important for healthcare professionals to recognize and respect these variations in order to provide appropriate pain management and support for patients. Choice A is incorrect because individuals do not behave the same way when in pain. Choice C is incorrect because pain tolerance is not solely biologically determined; cultural norms and individual differences also influence it. Choice D is incorrect because a patient's expression of pain can be influenced by various factors beyond the amount of tissue injury, such as emotional state and cultural beliefs.

2. An elderly Mexican-American woman with traditional beliefs has been admitted to an inpatient care unit. A culturally-sensitive nurse would:

• A. contact the hospital administrator about the best course of action.
• B. automatically get a curandero for her because it is not culturally appropriate for her to request one.
• C. further assess the patient's cultural beliefs and offer the patient assistance in contacting a curandero or priest if she desires.
• D. ask the family what they would like to do because Mexican-Americans traditionally give control of decisions to their families.

Correct answer: C

Rationale: When caring for a patient with traditional beliefs, especially one belonging to a culture like Mexican-American where folk or religious healers are important, a culturally-sensitive nurse should assess the patient's beliefs and preferences. By offering assistance in contacting a curandero or priest, the nurse acknowledges and respects the patient's cultural practices and provides holistic care that aligns with the patient's values. This approach helps build trust and ensures the patient receives care that is culturally appropriate and respectful. Choice A is incorrect as contacting the hospital administrator may not directly address the patient's cultural needs. Choice B is inappropriate as assuming the patient needs a curandero without assessment disregards individual preferences. Choice D is incorrect because while family involvement is valued in Mexican-American culture, the primary focus should be on the patient's individual preferences and autonomy.

3. When recording the childhood illnesses of a patient who denies having had any, which note by the nurse would be most accurate?

• A. Patient denies usual childhood illnesses.
• B. Patient states he was a 'very healthy' child.
• C. Patient states sister had measles, but he didn't.
• D. Patient denies measles, mumps, rubella, chickenpox, pertussis, and strep throat.

Correct answer: D

Rationale: Choice D is the most accurate note by the nurse as it lists specific childhood illnesses commonly experienced by children. By documenting that the patient denies having had these specific illnesses, the healthcare provider establishes a clear medical history record regarding these common childhood illnesses. This detailed documentation is essential for providing comprehensive care and evaluating potential risks or complications associated with these illnesses in the future. Choices A, B, and C are not as accurate as they do not provide a comprehensive list of common childhood illnesses that are routinely evaluated by healthcare providers. Choice A is too vague, Choice B focuses on the patient's perception of their health rather than specific illnesses, and Choice C only mentions measles, lacking the breadth of information provided in Choice D.

4. When providing culturally competent care, how should nurses incorporate cultural assessments into health assessments? Which statement is most appropriate when initiating an assessment of cultural beliefs with an elderly American Indian patient?

• A. "Are you of the Christian faith?"
• B. "Do you want to see a medicine man?"
• C. "How often do you seek help from medical providers?"
• D. "What cultural or spiritual beliefs are important to you?"

Correct answer: D

Rationale: The most appropriate statement to initiate an assessment of cultural beliefs with an elderly American Indian patient is to ask, "What cultural or spiritual beliefs are important to you?" This question encourages the patient to share their personal beliefs without assuming stereotypes or making generalizations. It allows the patient to express their individual cultural and spiritual practices, enabling nurses to deliver more personalized and culturally competent care. Choices A, B, and C are not as suitable. Choice A assumes a specific faith without considering the patient's actual beliefs. Choice B relies on a stereotype about American Indian culture, and Choice C focuses more on seeking medical help rather than exploring cultural beliefs.

5. Before a child undergoes a tonsillectomy, what information should the nurse collect?

• A. The child's birth weight
• B. The age at which they crawled
• C. Whether they have had the measles
• D. Reactions to previous hospitalizations

Correct answer: D

Rationale: Before a child undergoes a tonsillectomy, it is crucial for the nurse to gather information on the child's reactions to previous hospitalizations. This data helps in assessing potential fears or anxiety and in providing the necessary support and preparation for the upcoming tonsillectomy. Understanding the child's past reactions is vital for ensuring their comfort and well-being during the hospital admission and procedure. The other options provided are not directly relevant to the child's upcoming tonsillectomy procedure. Birth weight (Choice A) is not typically a factor considered before a tonsillectomy. The age at which a child crawled (Choice B) is a developmental milestone but not pertinent to the tonsillectomy. Having had measles (Choice C) is important for overall health history but not specifically crucial before a tonsillectomy.

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